Is interstitial cystitis hereditary. What evidence supports a genetic component in IC/BPS. How can genome-wide linkage analysis contribute to understanding IC/BPS etiology. What chromosome shows significant linkage to IC/BPS. How might genetic findings impact future IC/BPS research and treatment.

Understanding Interstitial Cystitis: A Complex Urological Condition

Interstitial cystitis (IC), also known as painful bladder syndrome (PBS), is a chronic urological condition characterized by pain and pressure in the bladder and pelvic area. The exact cause of IC/PBS remains unclear, but researchers have long suspected a potential genetic component to the disorder. A groundbreaking study conducted by researchers at the University of Utah and Intermountain Healthcare has shed new light on the hereditary aspects of IC/PBS.

Genome-Wide Linkage Analysis: Uncovering Genetic Clues

The research team, led by Kristina Allen-Brady from the Division of Genetic Epidemiology at the University of Utah, employed a genome-wide linkage analysis to investigate the genetic underpinnings of IC/PBS. This powerful genetic mapping technique allows researchers to identify regions of chromosomes that may harbor genes contributing to a particular trait or disorder.

What is genome-wide linkage analysis?

Genome-wide linkage analysis is a method used to identify regions of chromosomes that are shared more often than expected by chance among family members affected by a particular condition. By examining genetic markers across the entire genome, researchers can pinpoint areas that may contain genes involved in the development of the disorder.

Significant Linkage Evidence on Chromosome 3

The study’s most striking finding was the identification of significant linkage evidence for IC/PBS on chromosome 3. This discovery suggests that one or more genes located on this chromosome may play a crucial role in the development or progression of the condition.

Why is the identification of linkage on chromosome 3 important?

The localization of genetic linkage to a specific chromosome provides researchers with a targeted area for further investigation. By narrowing down the search to chromosome 3, scientists can focus their efforts on identifying specific genes or genetic variations that may contribute to IC/PBS susceptibility.

Implications for Understanding IC/PBS Etiology

The identification of a potential genetic link to IC/PBS represents a significant step forward in understanding the underlying causes of this complex condition. While previous research has suggested a familial component to IC/PBS, this study provides concrete evidence supporting a genetic basis for the disorder.

How does this genetic evidence impact our understanding of IC/PBS?

The discovery of genetic linkage on chromosome 3 opens up new avenues for research into the biological mechanisms underlying IC/PBS. By identifying specific genes or genetic pathways involved in the condition, researchers may gain insights into the molecular processes that contribute to bladder pain and dysfunction in affected individuals.

Potential for Improved Diagnosis and Treatment

The genetic findings from this study have important implications for both the diagnosis and treatment of IC/PBS. As our understanding of the genetic factors involved in the condition improves, it may become possible to develop more targeted and effective therapies.

How might genetic information be used to improve IC/PBS diagnosis?

In the future, genetic testing could potentially be used to identify individuals at higher risk for developing IC/PBS. This could lead to earlier diagnosis and intervention, potentially improving outcomes for patients. Additionally, genetic markers may help distinguish IC/PBS from other similar urological conditions, leading to more accurate diagnoses.

What are the potential implications for IC/PBS treatment?

Understanding the genetic basis of IC/PBS could pave the way for personalized medicine approaches. By identifying specific genetic variations associated with the condition, researchers may be able to develop tailored treatments that target the underlying molecular mechanisms driving symptoms in individual patients.

Limitations and Future Research Directions

While the findings of this study are promising, it’s important to note that genetic linkage studies have limitations. The identification of a linkage region on chromosome 3 does not necessarily pinpoint specific genes responsible for IC/PBS, but rather provides a starting point for further investigation.

• Additional studies with larger sample sizes are needed to confirm and refine the genetic linkage findings.
• Fine-mapping studies within the identified chromosome 3 region may help isolate specific genes or genetic variants associated with IC/PBS.
• Functional studies will be necessary to understand how genetic variations in the linked region contribute to IC/PBS pathophysiology.

The Role of Environmental Factors in IC/PBS

While this study provides strong evidence for a genetic component in IC/PBS, it’s crucial to remember that environmental factors likely play a significant role in the development and progression of the condition. The interplay between genetic predisposition and environmental triggers may be key to fully understanding IC/PBS etiology.

What environmental factors may contribute to IC/PBS?

Several environmental factors have been suggested to influence IC/PBS risk and severity, including:

1. Diet and nutrition
2. Stress levels
3. Hormonal fluctuations
4. Previous infections or injuries to the bladder
5. Exposure to certain chemicals or toxins

Future research should aim to elucidate how genetic and environmental factors interact to influence IC/PBS susceptibility and progression.

Collaborative Efforts and Patient Involvement

The success of this genetic linkage study highlights the importance of collaborative research efforts in advancing our understanding of complex conditions like IC/PBS. The involvement of multiple institutions and departments, including the University of Utah and Intermountain Healthcare, demonstrates the power of interdisciplinary approaches in medical research.

How can patients contribute to IC/PBS research?

Patients play a crucial role in advancing IC/PBS research. Some ways individuals can contribute include:

• Participating in clinical trials and genetic studies
• Sharing detailed medical histories and symptom information with researchers
• Joining patient advocacy groups to support research funding and awareness
• Providing biological samples for genetic and biomarker studies

By actively engaging in research efforts, patients can help accelerate the discovery of new insights into IC/PBS and potentially contribute to the development of improved treatments.

Implications for Related Urological Conditions

The genetic findings from this IC/PBS study may have broader implications for understanding other related urological conditions. Many chronic pelvic pain syndromes share similar symptoms and may have overlapping genetic risk factors.

Which related conditions might benefit from these genetic insights?

The genetic linkage evidence discovered for IC/PBS could potentially inform research into conditions such as:

• Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
• Overactive bladder syndrome (OAB)
• Vulvodynia
• Irritable bowel syndrome (IBS)

Investigating potential shared genetic pathways between these conditions could lead to a more comprehensive understanding of chronic pelvic pain disorders and potentially reveal new therapeutic targets.

The Future of IC/PBS Research and Patient Care

The identification of significant linkage evidence for IC/PBS on chromosome 3 marks an important milestone in the field of urology and pelvic pain research. As we move forward, this genetic insight opens up exciting possibilities for advancing our understanding of IC/PBS and improving patient care.

What are the next steps in IC/PBS genetic research?

Future research directions may include:

1. Conducting replication studies in diverse populations to confirm the chromosome 3 linkage
2. Performing fine-mapping studies to identify specific genes within the linked region
3. Investigating the functional consequences of genetic variations associated with IC/PBS
4. Exploring gene-environment interactions that may influence IC/PBS risk and severity
5. Developing genetic risk prediction models for IC/PBS susceptibility

As our understanding of the genetic basis of IC/PBS grows, we can anticipate significant advancements in diagnosis, treatment, and prevention strategies for this challenging condition. The collaborative efforts of researchers, clinicians, and patients will be crucial in translating these genetic discoveries into tangible improvements in patient care and quality of life for those affected by IC/PBS.

Significant Linkage Evidence for Interstitial Cystitis/Painful Bladder Syndrome on Chromosome 3

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. 2018 Jan;199(1):172-177.

doi: 10.1016/j.juro.2017.07.068.

Epub 2017 Jul 20.

Kristina Allen-Brady 
¹
, Kerry Rowe 
²
, Melissa Cessna 
³
, Sara Lenherr 
⁴
, Peggy Norton 
⁵

Affiliations

Affiliations

• ¹ Division of Genetic Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah. Electronic address: [email protected].
• ² Homer Warner Center for Informatics Research, Intermountain Healthcare Central Region and Intermountain Healthcare BioRepository, Salt Lake City, Utah.
• ³ Department of Pathology, Intermountain Healthcare Central Region and Intermountain Healthcare BioRepository, Salt Lake City, Utah.
• ⁴ Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah.
• ⁵ Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.

• PMID:

  28734863

• DOI:

  10.1016/j.juro.2017.07.068

Kristina Allen-Brady et al.

J Urol.

2018 Jan.

. 2018 Jan;199(1):172-177.

doi: 10.1016/j.juro.2017.07.068.

Epub 2017 Jul 20.

Authors

Kristina Allen-Brady 
¹
, Kerry Rowe 
²
, Melissa Cessna 
³
, Sara Lenherr 
⁴
, Peggy Norton 
⁵

Affiliations

• ¹ Division of Genetic Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah. Electronic address: [email protected].
• ² Homer Warner Center for Informatics Research, Intermountain Healthcare Central Region and Intermountain Healthcare BioRepository, Salt Lake City, Utah.
• ³ Department of Pathology, Intermountain Healthcare Central Region and Intermountain Healthcare BioRepository, Salt Lake City, Utah.
• ⁴ Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah.
• ⁵ Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.

• PMID:

  28734863

• DOI:

  10.1016/j.juro.2017.07.068

Abstract

Purpose:

Interstitial cystitis/painful bladder syndrome is a chronic pelvic pain condition of unknown etiology. We hypothesized that related interstitial cystitis/painful bladder syndrome cases were more likely to have a genetic etiology. The purpose of this study was to perform a genetic linkage analysis.

Materials and methods:

We identified interstitial cystitis/painful bladder syndrome cases using diagnostic codes linked to the Utah Population Database genealogy resource and to electronic medical records. For this analysis we used 13 high risk pedigrees, defined as having a statistical excess number of interstitial cystitis/painful bladder syndrome cases among descendants compared to matched hospital population rates. Case status was confirmed in medical records using natural language processing. DNA was obtained from stored, nonneoplastic, formalin fixed, paraffin embedded tissue blocks. Each pedigree had at least 2 cases with DNA available. Parametric linkage analysis was performed.

Results:

Pedigrees ranged in size from 2 to 12 genotyped cases for a total of 48 cases. Significant genome wide linkage evidence was found under a dominant model on chromosome 3p13-p12.3 (maximum heterogeneity θ logarithm of odds 3.56). Two pedigrees showed at least nominal linkage evidence in this region (logarithm of odds greater than 0.59). The most informative pedigree included 12 interstitial cystitis/painful bladder syndrome cases (pedigree θ logarithm of odds 2.1). Other regions with suggestive linkage evidence included 1p21-q25, 3p21.1-p14.3, 4q12-q13, 9p24-p22 and 14q24-q31, all under a dominant model.

Conclusions:

While the etiology of interstitial cystitis/painful bladder syndrome is unknown, this study provides evidence that a genetic variant(s) on chromosome 3 and possibly on chromosomes 1, 4, 9 and 14 contribute to an interstitial cystitis/painful bladder syndrome predisposition. Sequence analysis of affected cases in identified pedigrees may provide insight into genes contributing to interstitial cystitis/painful bladder syndrome.

Keywords:

chromosomes; cystitis; human; interstitial; pain; pair 3; pedigree; urinary bladder.

Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Interstitial Cystitis Causes

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By Yolanda Smith, B.Pharm.

The cause of interstitial cystitis remains unknown, despite the proposal of several theories that may explain the pathophysiology of the condition. Contrary to other types of cystitis, there does not appear to be an infection of the bladder and antibiotics do not offer a benefit to patients.

Inflammation that is associated with the bladder is thought to cause the symptoms, although medical experts do not agree upon the origin of this. Ulceration, scarring and stiffness of the bladder may play a role as causative factors of the inflammation.

There are several theories proposed by medical researchers that explain the possible causes of the condition, which are described in more detail below.

Image Credit: goffkein.pro / Shutterstock

Bladder Lining Theory

Damage to the bladder lining or epithelium may lead to inflammation and irritation of the bladder, resulting in the painful symptoms observed in patients with interstitial cystitis.

This could potentially lead to the leakage of urine from the bladder into the surrounding muscles and nerves. As a result, the pain and other symptoms may affect the entire abdominal area in close proximity to the bladder.

Possible situations that may affect the bladder lining and cause the condition include:

• Trauma to the bladder or spinal cord
• Over distention of the bladder (e. g. after infrequent bathroom breaks)
• Hypersensitivity of the pelvic nerves
• Abnormality of mast cells

Pelvic Floor Theory

The pelvic floor muscles play an important role in the control of the bladder and urination process. It has been proposed that a problem with the pelvic floor muscles may lead to inflammation of the bladder and act as a cause of interstitial cystitis.

This may result from a dysfunction of the pelvic floor muscles or weakening of the muscle over time for varying reasons.

Genetic Theory

Although a genetic link is unlikely to be the sole cause of interstitial cystitis, it may be possible for individuals to inherit a predisposition to the condition.

Some cases have been reported of blood relatives being affected, including cases of a mother and daughter, and sisters being affected. However, to date, no specific gene has been linked to an increased risk of the condition.

Nerve Damage Theory

In some patients, there may be damage to the nerves that are responsible for carrying sensory messages from the bladder. This has the potential to cause the pain associated with normal physiological events, such as the filling of the bladder.

Autoimmune Theory

An autoimmune response involving the destruction of the cells in the bladder has also been proposed as a cause of the condition. It is more common for individuals with an autoimmune disorder to suffer from interstitial cystitis, which suggests autoimmunity may be involved in the pathophysiology.

This theory is linked to several other related health conditions that may play a role in the cause.

Associated Conditions

Interstitial cystitis has been linked to several other conditions, due to the high frequency of patients that present concurrently with other symptoms and conditions. These include:

• Atopic allergy
• Chronic fatigue syndrome (CFS)
• Fibromyalgia
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Scleroderma
• Sjogren syndrome
• Systemic lupus erythematosus

This suggests that interstitial cystitis may be a component of a more complex syndrome, involving a broad number of factors and organ systems.

Continuing Research

Medical researchers continue to investigate the pathophysiology of interstitial cystitis, as successful treatment options will become clearer when more is known about the cause of the condition. In the future, it is hoped that targeted treatments could help to address the specific cause of the condition.

References

• http://www.nhs.uk/Conditions/interstitial-cystitis/Pages/Introduction.aspx
• http://www.healthline.com/health/interstitial-cystitis#Causes2
• http://www.emedicinehealth.com/interstitial_cystitis/page2_em.htm

Last Updated: Apr 14, 2021

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Interstitial cystitis – treatment and symptoms

Although women are classified as the weaker sex, their body is strong. What are the hardships of bearing, giving birth and feeding a child! However, unfortunately, the peculiarities of the anatomy sometimes also determine the adherence of women to certain diseases, in particular, inflammatory processes in the bladder, which often become chronic. About the common form of chronic interstitial cystitis – our article.

Epidemiology: facts and figures

Interstitial cystitis (IC) is a clinical syndrome characterized by frequent daytime and nighttime urination and pelvic pain.

The figures indicate that in 90% of cases, pathology occurs in the female share [1]. Previously, this disease was considered quite rare: it was assumed that it develops with a probability of no more than 5.1:1000 [2]. However, less encouraging data have been obtained in recent years. Thus, epidemiological studies have shown that IC is detected in American women with a probability of 60–70:100,000 [1]. At the same time, in Europe, the prevalence of the disease does not exceed 18 cases per 100,000 [3]. Such a noticeable difference in the epidemiological indicators of the Old and New Worlds can be explained both by differences in diagnostic approaches and significant differences in lifestyle, nutrition, etc. In the Russian Federation, unfortunately, there are no statistics on the prevalence of IC, and domestic specialists rely on how as a rule, to the information of Western colleagues.

It should be noted that neither marital status, nor the number of sexual partners, nor the level of education affect the likelihood of developing IC [1]. The average age of onset of the disease is 40 years, however, cases of pathology development in young patients, including children, are not excluded.

Causes of interstitial cystitis and risk factors

Sadly, the etiology of IC is still not fully understood. A certain pathogenetic role in the development of the disease can be played by the deficiency of glycosaminoglycans in the epithelial layer of the bladder, which leads to increased permeability of the adjacent submucosal tissues for toxic substances contained in the urine [4].

Perhaps the infectious aspect is important, however, it has not yet been possible to accurately identify the causative agent of the disease and even definitely evaluate its role in the pathogenesis of IC. Some experts believe that the pathology may be associated with infection by some yet undiscovered slow-growing virus or an extremely fastidious bacterium.

According to other data, dysfunction of the pelvic muscles or urination disorders, as well as autoimmune diseases, are associated with IC.

Previously, scientists ruled out the possibility of a tendency to inherit IC, but in 2005, the results of a study evaluating the occurrence of the disease in monozygotic and dizygotic twins were obtained. They indicate that chronic interstitial cystitis is characterized by at least a partial genetic predisposition [5].

It is known that IC often occurs against the background of some chronic diseases, including inflammatory bowel disease, systemic lupus erythematosus, irritable bowel syndrome, fibromyalgia and atopic allergy [1]. In addition, IC is often associated with mental disorders, in particular depression.

Risk factors that predispose to IC include:

• Gender. As already mentioned, 90% of cystitis is observed in women. It is important to note that in men, the symptoms of this disease are most often associated with concomitant prostatitis.
• Skin and hair colour. Fair-skinned, red-haired women are at higher risk of developing IC.
• Age. Most cases are diagnosed for the first time in patients aged 30 and older.
• Chronic pain syndrome, such as irritable bowel syndrome or fibromyalgia.

How does IC manifest itself?

The disease usually begins acutely, when the patient suddenly, at some certain period of time, discovers problems with urination. Often, patients associate the onset of symptoms of IC with a urinary tract infection.

First of all, the pathology is characterized by frequent and painful urge to urinate, which is accompanied by a feeling of pressure, discomfort and pain in the pelvic area, as well as a feeling of incomplete emptying of the bladder. In addition, sexual disorders appear, including pain during intercourse, decreased libido and orgasm frequency.

Chronic cystitis is characterized by alternating periods of exacerbation and partial or even complete remissions, during which there are no symptoms. The duration of acute periods can vary considerably, from a few days to months or even years. On average, 8 months after the onset of the disease, 50% of patients will experience spontaneous remission of various lengths [1]. In women, the symptoms of interstitial cystitis sometimes fluctuate in severity depending on the phase of the menstrual cycle.

Diagnostic measures

Unlike urinary tract infections, interstitial cystitis cannot be diagnosed by routine urinalysis or culture. The fact of the presence of IC is confirmed on the basis of a characteristic clinical picture, but only after the exclusion of other possible diseases, including genitourinary infections, urolithiasis, bladder cancer, kidney pathologies, multiple sclerosis, endometriosis, and others [6]. The key step in the diagnosis of IC is cystoscopy, an endoscopic diagnosis of the bladder using a urethrocystoscope. During the procedure, fluid may be injected into the bladder cavity in order to assess the functional state of the organ.

In some cases, during cystoscopy, a biopsy of the bladder is performed to exclude malignant processes and other rare causes of pain.

IC treatment principles

IC therapy has two main objectives: pain relief and reduction of the inflammatory process. Unfortunately, these goals are not easy to achieve. In most cases, the treatment of interstitial cystitis in women and men is a serious problem in restoring the normal quality of life of patients. There is no well-defined, standard treatment that would alleviate the suffering of most patients. As a rule, the technique is selected based on the individual response of the patient. At the same time, given the likelihood of spontaneous remission, expensive or aggressive treatment is prescribed with caution [1].

An integral part of therapy is the formation in patients of an idea about, alas, the chronic course of the disease, its prognosis and difficulties with treatment. Diet therapy plays an important role in the successful control of IC.

Diet therapy

Some studies have shown that in almost 90% of patients, an exacerbation of the disease is associated with the intake of certain foods. The list of “dangerous” products includes [1]:

• Coffee
• Alcohol
• Monosodium glutamate
• Tomato
• Vinegar
• Citrus
• Spicy food
• Chocolate
• Cranberry juice

s, or add them to the diet occasionally. In order to reflect the relationship between the introduction of various foods into food and the exacerbation of symptoms of IC, it is advisable to keep a food diary. Next, consider how it is customary to treat interstitial cystitis.

Pharmacotherapy

The most common mistake in the drug therapy of IC is associated with the incorrect prescription of antibiotics, which are absolutely ineffective in such cases. The roots of this misconception lie in the initially incorrect diagnosis, which, as a rule, turns out to be empirically established, based solely on clinical symptoms, bacterial inflammation of the bladder. It can be said that the key to effective treatment of interstitial cystitis is to correctly determine the causes of symptoms.

Drug therapy for interstitial cystitis involves the appointment of oral drugs and intravesical instillations of drugs.

Among drugs for internal use, it should be noted:

• Tricyclic antidepressants (amitriptyline). Low-dose drugs in this group help to relax the bladder and also prevent the release of substances that can provoke pain and inflammation. In addition, tricyclic antidepressants improve the quality of sleep. According to a randomized, double-blind, placebo-controlled study, amitriptyline provides a statistically significant improvement in IC [7].
• Antihistamines , in particular hydroxyzine, which in the Russian Federation belongs to the pharmacological group of anxiolytics (tranquilizers).

  Antiallergic drugs block the release of histamine from mast cells located in the walls of the bladder, which helps to reduce pain, the severity of inflammation, as well as reduce the number of urges to urinate, including at night. It should be borne in mind that hydroxyzine can have a sedative effect, so it is preferable to prescribe it at bedtime.

• NSAIDs. Naproxen, ibuprofen, paracetamol, meloxicam, celecoxib and other NSAIDs are used as anti-inflammatory and analgesic agents that can relieve mild to moderate pain in IC.

The topical anti-inflammatory dimethyl sulfoxide is widely used for intravesical instillations and is the only drug approved for this use by the US Food and Drug Administration (FDA). Against the background of the introduction of dimethyl sulfoxide, the walls of the bladder relax, pain and the severity of inflammation decrease. The standard course of treatment includes six instillations (one per week for six weeks).

Other methods of treatment

In addition, physiotherapeutic procedures (endovesical iontophoresis, laser photoirradiation of the bladder, UHF, inductotherapy, balneotherapy, etc.) can be used for IC, as well as surgical treatment, which is performed only in severe stubborn cases. During the surgical intervention, they try to achieve an increase in the bladder, optimize the outflow of urine, and resect the ulcerative lesions of the mucosa (if any).

Interstitial cystitis prognosis

Despite the fact that most often the disease has an intermittent course, which is characterized by alternating exacerbations and remissions, severe cases are not excluded, in which there is a gradual and persistent progression of symptoms of IC, which cannot be stopped. Sometimes it is possible to alleviate the clinical picture of the disease with the help of self-control measures, such as quitting smoking, increasing physical activity, reducing the influence of stress factors, choosing loose underwear and clothes, and, of course, dieting.

Nevertheless, urologists acknowledge that there are no remedies to prevent or significantly reduce the severity of IC symptoms.

The disease seriously reduces the quality of life, so much so that in the United States, for example, this diagnosis gives rise to a disability. A work presented by American scientists led by Kimberly Hepner in 2012 showed that in a group of adult women with symptoms of IC, 11% of respondents considered suicide as a way to free themselves from the torment associated with their disease [8]. Research data suggest that the impact of IC on quality of life can be comparable to the suffering experienced by patients in the end stage of renal failure or rheumatoid arthritis [9, 10].

All this disappointing information suggests that modern scientists are faced with the difficult task of finding new means and methods of treating chronic cystitis, a serious disease that still remains one of the most complex and still unsolved mysteries in world medicine.

References

1. Rovner E. S., Kim E. D. Interstitial cystitis //Medscape Reference. May. — 2011.
2. Konkle KS, Berry SH, Elliott MN, Hilton L, Suttorp MJ, Clauw DJ, et al. Comparison of an interstitial cystitis/bladder pain syndrome clinical cohort with symptomatic community women from the RAND Interstitial Cystitis Epidemiology study. J Urol. Feb. 2012 187(2):508–12.
3. Curhan G. C., Speizer F. E., Hunter D. J. Epidemiology of interstitial cystitis: a population based study // The journal of urology. – 1999. – Vol. 161.—P. 549–552.
4. Parsons CL, Boychuk D, Jones S, et al. Bladder surface glycosaminoglycans: an epithelial permeability barrier. J Urol. 1990 Jan. 143(1):139–42.
5. Warren JW, Keay SK, Meyers D, Xu J. Concordance of interstitial cystitis in monozygotic and dizygotic twin pairs. Urology. Jun. 2001 57 (6 Suppl 1):22–5.
6. Hsieh, CH; Chang, W. C.; Huang, M.C.; Su, T.H.; Li, YT; Chiang, H. S. (December 2012). “Treatment of interstitial cystitis in women”. Taiwan Journal of Obstetrics & Gynecology. 51(4): 526–532.
7. van Ophoven A, Pokupic S, Heinecke A, Hertle L. A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol. 2004 Aug. 172(2):533–6.
8. Hepner, Kimberly A.; Watkins, Katherine E. ; Elliott, Marc; Clemens, J. Quentin; Hilton, Lara; Berry, Sandra H. (June 2012). “Suicidal ideation among patients with bladder pain syndrome/interstitial cystitis”. Urology. 80(2): 280–285.
9. American Urological Association Guideline: Diagnosis and Treatment of Interstitial Cystitis. Bladder Pain Syndrome [January 2011]” (PDF). American Urological Association. Retrieved 1 April 2011.
10. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA. Ho N, Koziol J, Parsons CL. Epidemiology of Interstitial Cystitis, in G. Sant (Ed.), Interstitial Cystitis. Philadelphia: Lippincott-Raven Publishers, 1997; 9–15.

Peculiarities of treatment of cystitis in women by a urologist

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Inflammation of the bladder is one of the most common diseases among women. Cystitis can occur in various forms. For all issues of prevention, treatment of pathology, it is necessary to contact a urologist in a timely manner. This approach to health care is the key to the effectiveness of disease control measures.

Main types of pathology

Inflammation of the bladder can be infectious and non-infectious. In the second case, the disease often occurs as a result of hypothermia. The cause of infectious cystitis: pathogenic bacteria. The latter can “move” into the bladder from other parts of the excretory system. The main difference between acute cystitis and recurrent cystitis: the first begins suddenly, is characterized by severe symptoms, rapid development. Recurrent inflammation is called a sluggish form of the disease. The symptoms of this pathology are regularly exacerbated. Without taking timely medical measures, such cystitis gradually becomes chronic.

According to the severity of the consequences, the disease is divided into complicated and uncomplicated. In the second type of cystitis, the urinary system continues to function within the normal range, there are no deviations in the structure of the internal organs. Complicated inflammation of the bladder is characterized by opposite properties, it causes the emergence of new, including renal, pathologies.

Is the structure of internal organs a precondition for disease?

In medical practice, the most common form of the disease is acute uncomplicated cystitis. The length of the female urethra is 5-10 times shorter than the male urethra. This part of the excretory system in women is wider, close to the anus, the vagina, and does not have additional barriers against pathogenic bacteria. The male urethra is divided into sections. The prostate gland (located next to the bladder) protects it from infection with pathogenic microbes. This difference in the structure of the excretory systems is the main reason for the susceptibility of women to cystitis.

Can provoke the disease:

• changes in the location of the urethra, including those due to trauma to internal organs,
• excessively active sex life (especially if it is accompanied by a constant change of partners),
• use of barrier contraceptives with spermicides,
• infection in childhood of the urinary tract.

Predisposition to cystitis can be inherited. If a woman had an illness during pregnancy, the pathology of the excretory system will affect the health of the fetus.

About the diagnosis of the disease

The primary condition for a successful fight against cystitis: accurate diagnosis. For the urologist, information about the causative agent of the disease is extremely important. It could be E. coli (E. coli). It causes up to 95% of infectious pathologies. In some cases, other bacteria can provoke the disease: staphylococci, Klebsiella, Proteus.

These symptoms in 90% indicate cystitis and its acute form:

1. Pain during frequent urination.
2. Unpleasant pungent smell of urine, the presence of blood particles in it (hematuria).
3. Pain in the lower abdomen.

There is no high temperature among the main signs of the disease. When body temperature rises above 37.3 ° C, in most cases, doctors diagnose pyelonephritis and other kidney diseases. An important point: acute pathologies of the excretory system may be accompanied by hematuria without pain symptoms.

The complexity of diagnosis lies in the fact that signs of cystitis appear in the presence of neoplasms. In such cases, there is no blood in the urine, and during chemotherapy, radiotherapy, and taking various medications, the opposite is true. A preliminary diagnosis of “acute cystitis” can be made during the initial visit to the urologist, but laboratory tests follow. They are necessary to determine the causative agent of the infection, to make adjustments to the treatment regimen. During the initial examination, the urologist has the right to make a preliminary diagnosis and prescribe medications to reduce the intensity of symptoms and the rate of development of the pathology. And the data of the general analysis of urine is quite enough to confirm the presence of cystitis.

If it proceeds without complications, the urologist may not prescribe an additional bacteriological analysis. Such a study includes the method of bacterial seeding. It consists in the fact that specialists place microorganisms in a nutrient medium and monitor the development of the latter. Bacteriological analysis is required when there is a suspicion of cystitis in a pregnant woman, it is likely that acute pyelonephritis occurs in parallel. Bakposev is used to determine the causes of the protracted course of the pathology, its atypical development. If during the study the leukocyte count is 10 times higher than normal, this indicates the presence of an acute form of cystitis.

An important nuance: ultrasound diagnostics is not able to detect inflammation of the bladder in all cases, because its methods for diagnosing cystitis are not the main ones. This type of research is actively used to detect neoplasms, abnormalities in the structure, the presence of stones in the internal organs.

Cystitis treatment specifics: why is one antibiotic not enough?

Inflammation of the bladder rarely requires hospitalization. Pregnant women, those who have severe intoxication, are diagnosed with infectious pathologies of the kidneys, or there is a risk of the latter are usually placed in the station. An experienced urologist will need 2-3 days to treat cystitis. The fight against chronic pathology lasts for several weeks. Recurrent cystitis is the most difficult to treat due to the fact that pathogenic organisms (including E. coli) quickly develop resistance – resistance to the effects of medications. To fight the disease, it is necessary to increase the dosage of antibiotics. This approach negatively affects the state of health.

A new word in the treatment of cystitis is the drug “Mamiror”. Its main difference from analogues: it simultaneously destroys pathogenic fungi, disrupts synthesis and prevents the reproduction of pathogenic bacteria. Drug molecules do not allow most microorganisms to develop resistance. However, for effective treatment of the pathology of one drug is not enough! The list of measures against the disease includes bed rest or bed rest. Its duration depends on the characteristics of the disease, the severity of the symptoms. The diet for cystitis is strictly limited to plant foods, dairy products. Boiled meat, fish are added to the diet in limited quantities, in the acute form of the pathology they are completely excluded from the diet.

For inflammation of the bladder:

1. Do not eat any spicy, fried foods.
2. Pickles and spices are prohibited.
3. The use of alcoholic beverages, smoking is not allowed.

Alcohol, nicotine reduce the effectiveness of drugs, impair the functioning of organs, can cause acute intoxication of the body and lead to death.

Antibacterial therapy is based on the principle of a pyramid. After using a wide range of drugs, the doctor analyzes the results of the tests, the antibiogram and prescribes new medications that are aimed at destroying certain infectious agents. At this stage of treatment, specialists can make adjustments to the use of painkillers, antispasmodics, antiseptics.

About supplements and surgeries

Diuretic herbs during cystitis relieve pain symptoms, accelerate the removal of toxins and harmful substances from the body. A number of phytotherapeutic preparations are not inferior to synthetic agents in terms of their effectiveness. Official medicine recognizes the use of medicinal herbs, as well as physiotherapy. Doctors rarely use surgery to treat cystitis. The operation remains the only chance of saving life when the stone blocks the outflow of urine, a neoplasm, a foreign body in the bladder, and deformation of the walls of the internal organ are found. It is important to understand: in any case, self-treatment of pathology with antibiotics, phytotherapeutic, physiotherapeutic methods is unacceptable. It can accelerate the transition of the disease to the chronic stage, causing irreparable harm to health. At the first suspicion of cystitis, seek the services of a urologist! Strictly follow the doctor’s recommendations.